ADHD Ads Target Back-to-School Crowd

Overprescribed vs. Underserved

For anyone who has been paying any attention at all, it should come as little surprise that drugs for ADHD are big business.

Psychological professionals who work with children and adolescents say there is a notable spike in office visits for the condition -- and hence, ADHD drug prescriptions -- at the beginning of the school year.

"We certainly see an increase," said Jennifer Kurth, adolescent psychiatrist at Northwestern Memorial Hospital's Warren Wright Adolescent Center in Chicago. "Usually our field in general starts to see a lot of kids throughout the first few months of school."

ADHD is thought to affect anywhere from 3 to 12 percent of school-age children -- a figure that works out to as many as 3.8 million kids. This makes it one of the most common childhood disorders in the country.

And it is possibly also one of the most lucrative. Medicines to treat the disorder -- such as Ritalin, manufactured by Novartis Pharmaceuticals Corp., Concerta by Johnson & Johnson and Adderall by Shire U.S. Inc. -- are estimated to rake in more than $1 billion annually in sales.

So while researchers continue to point to a wide range of possible ADHD causes ranging from prenatal alcohol exposure to genetics, some parents and doctors suspect that the drugs for the condition may be overprescribed.

"If a child, after a proper diagnostic evaluation actually has ADHD, then the drug may make sense," Wolfe said. "But it is always a poor balancing of benefits and risks to prescribe a drug that is unnecessary, taking the risks of the drug, which can be substantial, while getting no benefit."

Many physicians in the field, however, say that this is a dangerous misapprehension.

"I think there were a couple of reports in early 2000 that showed a dramatic rise in the prescription rates of these drugs. These reports, while accurate, do not convey the whole picture," said Walkup, who added that up to half of the children who have ADHD go untreated.

"I certainly think that it's important to remember that ADHD affects 8 to 10 percent of school-aged children," Kurth said. "We're prescribing the drug more frequently because we are catching those who hadn't been treated in the past."

To Advertise or Not to Advertise?

It's the fact that these drugs are advertised so heavily and in a targeted way that has some researchers and regulators concerned. Currently, the United States and New Zealand stand alone as the only nations that allow drug companies to advertise their prescription-only products directly to consumers.

And the very nature of ADHD drugs -- some which have been shown in the past to have rare but potentially deadly side effects on the heart and significant abuse potential -- may beg for stricter regulation.

Julie Donohue, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, published a study in the New England Journal of Medicine on Aug. 16 of this year that found that drug companies spending on advertising since such marketing became legal in 2001 has more than tripled. Her research also suggests that regulatory efforts by the FDA have decreased over time.

"Some people might have ethical issues with advertising prescription drugs for children in the first place," she said. "My whole point is that the rules that we have on the books are adequate, they just need to be enforced."

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